SMALL ()
MED-SMALL ()
MEDIUM ()
MED-LARGE ()
LARGE ()
X-LARGE ()
XX-LARGE ()

Patient Referrals

Thank you for your interest in our practice and consideration of entrusting us with the care of your patient.

If you have an individual and/or family that you would like to refer, please contact us as we would love to connect with you. We know the importance and effectiveness of integrated healthcare plans and simply ensuring that individuals and families seeking service be guided to professionals who can effectively address their healthcare needs.

We honor referrals via telephone, email, and fax. If you would like to discuss a referred patient in detail, please attach a release of Information (ROI) to the form below or fax it to us at 386-518-6024 so that we can communicate using all relevant clinical information. We hope to not only continue connection with your patient, but also with you as the referring provider.

Please complete the form below to provide us with information that would help us understand how we can meet your patient's needs and/or attend to your professional inquiries. Fields marked with '*' are required.

Hancock-Smith Pediatric & Behavioral Health, LLC
Office Address: 15260 NW 147th Drive, Suite 200, Alachua, FL 32615
Mailing Address: PO Box 305, Alachua, FL 32616-0305
Phone: 386.518.6006
Fax: 386.518.6024